Lee Geunin, Kim Sol, Chang Shihwan, Sohn Hojoon, Kang Young Ae, Park Youngmok
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2024 Jul;87(3):386-397. doi: 10.4046/trd.2023.0193. Epub 2024 Apr 9.
Despite the global increase in nontuberculous mycobacterial pulmonary disease (NTM-PD), clinical characteristics show geographical variations. We investigated the clinical characteristics of patients with NTM-PD in South Korea.
We systematically reviewed articles concerning patients with NTM-PD in South Korea until February 2022. Individual participant data, regardless of treatment, were collected using a standard case report form.
Data of 6,489 patients from 11 hospitals between 2002 and 2019 were analyzed. The mean age was 61.5±11.7 years, of whom 57.7% were women. Mycobacterium avium (41.4%) and Mycobacterium intracellulare (38.4%) comprised most of the causative species, followed by Mycobacterium abscessus subspecies abscessus (8.6%) and M. abscessus subspecies massiliense (7.8%). Bronchiectasis (59.4%) was the most common pulmonary comorbidity. Although reported cases of NTM-PD increased over the years, the proportions of causative species and radiologic forms remained similar. Distinct clinical characteristics were observed according to age and sex. Men were older at the time of diagnosis (median 63.8 years vs. 59.9 years, p<0.001), and had more cavitary lesions than women (38.8% vs. 21.0%, p<0.001). The older group (≥65 years) had higher proportions of patients with body mass index <18.5 kg/m2 (27.4% vs. 18.6%, p<0.001) and cavitary lesions (29.9% vs. 27.6%, p=0.009) than the younger group.
We conducted a meta-analysis of the clinical characteristics of patients with NTM-PD in South Korea, and found age- and sex-related differences in disease- specific severity. Further investigation would enhance our comprehension of the nature of the disease, and inherited and acquired host factors.
尽管全球非结核分枝杆菌肺病(NTM-PD)的发病率有所上升,但其临床特征存在地域差异。我们对韩国NTM-PD患者的临床特征进行了调查。
我们系统回顾了截至2022年2月有关韩国NTM-PD患者的文章。使用标准病例报告表收集个体参与者的数据,无论其治疗情况如何。
分析了2002年至2019年间11家医院6489例患者的数据。平均年龄为61.5±11.7岁,其中57.7%为女性。鸟分枝杆菌(41.4%)和胞内分枝杆菌(38.4%)是主要致病菌种,其次是脓肿分枝杆菌脓肿亚种(8.6%)和脓肿分枝杆菌马西利亚亚种(7.8%)。支气管扩张(59.4%)是最常见的肺部合并症。尽管多年来NTM-PD报告病例有所增加,但致病菌种和放射学类型的比例保持相似。根据年龄和性别观察到明显的临床特征。男性诊断时年龄较大(中位数63.8岁对59.9岁,p<0.001),空洞性病变比女性更多(38.8%对21.0%,p<0.001)。老年组(≥65岁)体重指数<18.5kg/m2的患者比例(27.4%对18.6%,p<0.001)和空洞性病变比例(29.9%对27.6%,p=0.009)高于年轻组。
我们对韩国NTM-PD患者的临床特征进行了荟萃分析,发现了疾病特异性严重程度存在年龄和性别相关差异。进一步的研究将增进我们对该疾病本质以及遗传和获得性宿主因素的理解。